14 Fla. L. Weekly Supp. 584a
Insurance — Personal injury protection — Coverage — Medical expenses — Unlicensed provider — Charges for massage therapy are non-compensable for dates of service on which medical provider did not have massage therapy establishment license
PHYSIATRIC PAIN & MEDICAL REHABILITATION CLINIC, as Assignee of Kunta K. Braswell, Plaintiff, v. PROGRESSIVE AUTO PRO INSURANCE COMPANY, a corporation authorized and doing business in the State of Florida, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 05-CC-2060. March 14, 2007. Antoinette Plogstedt, Judge. Counsel: Mark A. Nation. George Milev, Adams & Diaco, P.A., Tampa.
AMENDED ORDER ON DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
(Massage Establishment License)
THIS CAUSE came on for hearing January 22, 2007, on Defendant’s Motion for Final Summary Judgment, and the Court having heard argument of counsel and being otherwise fully advised in the premises, ORDERS AND ADJUDGES as follows:
1. Defendant’s Motion for Final Summary Judgment is DENIED, but this Court does GRANT Partial Summary Judgment to Defendant, Progressive.
2. In this lawsuit for recovery of PIP benefits, Plaintiff claims, among other things, recovery for usual and customary reductions made by Progressive for massage therapy services. Plaintiff likewise claims recovery for usual and customary reductions for treatment modalities other than massage therapy services.
3. The parties agreed at the hearing that the Plaintiff, medical provider, did not yet maintain a massage establishment license during all of the dates of service wherein massage therapy was rendered pursuant to the newly-enacted (at the time) Section 480.043(1), Florida Statutes (2003).
4. Based upon the above, partial summary judgment is hereby granted in favor of Defendant for the following dates of services for CPT Code 97124 (massage therapy): 10/8/03, 10/9/03, 10/10/03, 10/15/03, 10/16/03, 10/17/03, 10/20/03, 10/24/03, 10/28/03, 10/30/03, 11/05/03, 11/07/03, 11/12/03, 11/14/03, 11/18/03, 11/24/03, 11/26/03, 12/9/03, 1/15/04 and 1/23/04 as being non-compensable charges for massage therapy.
5. Plaintiff shall not recover for massage therapy services for the above-dates of service requested in the Complaint.
6. As to Defendant’s request, however, for final summary judgment on all the other services in dispute, this court hereby DENIES Defendant’s request.
